A need for 'moral leadership' in family planning

LONDON — The newly appointed executive director of the United Nations Population Fund has described a situation of injustice when it comes to women and girls’ access to reproductive health and rights, saying that their needs are being “relegated to the bottom of the heap.”

Dr. Natalia Kanem, who was promoted to the position earlier this month, talked to a small audience of stakeholders in London on Tuesday about changes to family planning policy in the United States. President Donald Trump defunded the UNFPA in April, depriving the organization of its second-largest donor, as had previously taken place under the administration of President George W Bush.

"We're really sad that it's come to this,” said Kanem. “This is the second time that this has happened to UNFPA. And for me it's particularly disappointing because the weight of moral leadership has to be on the side of justice and fairness, and there's nothing more unfair than having a girl or a woman and her desires being relegated to the bottom of the heap.”

“We really believe that in every part of the world family planning has shown itself as something that is normal and natural, in a country like the United States and in other places as well,” she said.

However, she also spoke of the counter-movement that has emerged following Trump’s decisions earlier this year to defund the UNFPA and reinstate an expanded version of the “global gag rule,” which prohibits non-U.S. organizations involved in work related to abortion from receiving U.S. government funding for any of their activities. Soon afterward, a number of governments and donors came together to form the family planning movement She Decides; while U.N. Women’s HeForShe campaign has also seen renewed momentum.

“We feel that it has been quite important to have the counterweight that we've seen around the world,” Kanem said. “Nairobi, Australia, wherever you looked: women marched. Women created the She Decides movement, women created the HeForShe movement. We've had a lot of acknowledgement of gender inequality, and the full spectrum of rights is where we should be going.”

The U.S. contributed $69 million a year to UNFPA before it withdrew funding based on an insinuation that the organization had been complicit in forced abortions and sterilizations in China under the country’s One Child Policy — an accusation that has been made against it by previous Republican governments. As Devex reported, UNFPA strongly denied the allegation, noting that most of its work in China is not focused on reproductive health but on gender-based violence, ageing populations and other issues.

Kanem said the organization now faces an overall funding gap of $700 million until 2020. The latest figures show that there are 214 million women and girls around the world in need of safe and effective family planning methods, and about 830 women die each day from complications related to pregnancy and childbirth.

Asked by a member of the audience how UNFPA could approach politically contentious issues such as abortion and comprehensive sexuality education, she replied that these are “fundamental issues for women to have safe passage through childhood.”

“For UNFPA, where the law allows abortion, we advocate for it to be safe; and in every country, we advocate for post-abortion care, and also filling in on the front end — the understanding that leads to the avoidance of an unfortunate situation to begin with,” she said.

“Similarly, for comprehensive sexuality education, we are strong advocates of giving young people the powerful, life-saving information they need now," she added.

Kanem was in London to launch the UNFPA’s annual flagship report, “State of World Population,” which this year stressed the relationship between family planning and economic inequality.

“Inequality of reproductive health and rights disenfranchises untold millions of women, and it also bolsters social and economic systems that enable a privileged few to rise to the top and stay there,” Kanem said in discussing the report. “This inequality also drags the vast majority to the bottom, robbing individuals of their rights and denying whole nations of the foundations for development.”

For countries seeking to tackle economic inequality, Kanem said, a good place to start is by addressing related inequalities, like reproductive health.

Kanem has worked with UNFPA for a number of years, first as its representative in Tanzania and then as deputy executive director of programs under Babatunde Osotimehin, the organization’s popular former chief who died suddenly earlier this year. Kanem took over as acting executive director for four months before being appointed to the position officially at the beginning of October, becoming the first Latin American to take the post. Her appointment was warmly welcomed by the family planning community.

In London, she spoke about the impressive “return on investment” offered by family planning, arguing that there is clear economic case for the investment. She said it had been “inspiring” to be in the U.K.’s capital city a few months earlier for the London Family Planning Summit, which raised about $5 billion in pledges.

But Kanem added that starting with a resource gap “really does mean that we need to be all hands on deck, and we need to be creative, and we need to be fairly aggressive in shouting from the rooftops” that equitable access to family planning is a question of justice.

Because of the urgency of the issue, "we have to explain ourselves better, and we have to be more vocal and more visible and more willing to go for it, even to those who disagree, so that we have the opportunity for dialogue and to discuss how this is really life-changing," she said.